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REQUIRED SUBMITTALS <br />All of tht following information mint ho submitted bv the applicaHon d«»arf|inf fluff <br />flrder for vour application to be gnn»Heri.H rnn.pl>#e! ..... ' <br />- Completed Application Form <br />---- Certified Property Owners List of owners within 150', labels and plat man fvou <br />must obtain fhic list J___r.____Tf______,r,_ Z. ^ <br />I <br />2,, »iumi iauc;i:> iina piai map (VOU <br />must obtain this list, labels and map from Hennepin County Department of <br />Fmance, A-603, Go\1 Cenfer, 349-5910). <br />Certificate of Survey (signed by a licensed surveyor) and include hardcover <br />calculations as required. In addition, provide one (1) copy 8'/S" x 11" for <br />reproduction. <br />Topographic survey (existing and proposed elevations) if any changes in existing <br />grade are proposed. In addition, provide one (1) copy S'/i" x 1 1" for reproduction. <br />Sketches or plans of floor & elevation views (provide one (1) copy Sid" x 11") <br />List of the legal names (include marital status) of all persons with an interest in <br />foe property. This would include name(s) of applicant(s) if not current owner(s). <br />As an addendum to this application, please attach a separate list of any other <br />persons you wish notified of this application. <br />Additional items as may be requested by City staff <br />Applicant and Property 0«rar must sign this application. Please remember that y,ui <br />Mrihlltt lPPliMH()ll IS not fomnlet. if Ihe nhny, infnrm.tinn I.,, n„, K... <br />APPLICANT'S SIGNATimE <br />The applic^t hereby agrees to provide ail information requited or requested by the Zoning <br />Adm.n.stralor, agrees to pay additional fees (staff time not covered W original fee payTnt) <br />Md/or consultant expenses incurred in review of this application,' uid^cettifies ufat the <br />mfomiation supplied is true and correct to the best of his/her knowledge. <br />Applicant's Signature _ <br />5 <br />6 <br />7 <br />8 <br />Date ^4 g <br />OWNER'S SIGNATURE <br />The owner hereby acknowledges and agrees to this application and further authorizes reasonable <br />memb^rfo^' Commission memberT™“cnmembers for purposes ot investigation and verification of this request. '-ouncii <br />Owner’s Signan re f7 . . a> —• rx ^ <br />Applicant must have all submittals into the <br />Date <br />^xr..sa.aa^.„.. syc.uujj. r.cuuung ^.ommission Meetings are held on the third Mondav ot each <br />cZmisstaf ind"c ’”“'1 (he PlanningCommission and Coune.l, If an appi.eant is unable to attend a scheduled meetina nlease <br />make arrangements to have an authorized acent attend in vnnr wi j 7 . picase <br />& zoning Office of this change prior 'o <br />. <br />/ <br />■ Q <br />. a. ^ <br />V <br />t-i ■V <br />iV .. '